Political will vital in efforts to end tuberculosis

A world free of tuberculosis (TB) is possible by 2045 if increased political will and financial resources are directed towards priority areas, a new study has shown.

Some of the suggested interventions include increasing research to develop new ways to diagnose, treat and prevent the infectious disease.

But funding this response, the Lancet Commission on TB report says, will require substantial investments and accountability mechanisms to ensure that promises to eliminate TB are kept and targets are reached.

As the World TB Day is marked today under the theme “It’s time”, scientists are exploring new interventions and innovations to ensure that cases of the disease are not only detected and treated, but also that patients adhere to their medication.

DIAGNOSIS

The Health ministry has launched a four-year national strategic plan for tuberculosis, leprosy and lung disease (2019-2023), aimed at enabling the diagnosis of at least 597,000 people with TB by 2023, in addition to providing preventive therapy to at least 900,000 Kenyans who are at risk of infection.

In a couple of weeks, the government will also rollout a new test meant to help detect tuberculosis in people who do not show symptoms of the disease.

The test will mainly be carried out in rural areas where many people are not diagnosed early enough.

“Often, whenever people cough, they delay going to hospital to find out if what they have is a common cold or TB. For some, it is the long distance to, or lack of a health facility, that just puts them off. That is why we are taking care to them,” the ministry says.

TRANSMISSION

When a person with infectious TB coughs or sneezes, droplets containing the TB bacteria known as mycobacterium tuberculosis are released into the air.

According to the Centres for Disease Control and Prevention (CDC), if another person inhales air containing these droplets, they can get infected.

“However, not everyone infected with the bacteria becomes sick. As a result, two TB-related conditions exist: Latent TB infection and TB disease,” CDC notes.

People with latent TB infection do not feel sick and do not have any symptoms, notes Dr Joseph Sitienei, who heads the Division of Communicable Disease Prevention and Control.

TREATMENT

Whereas these people incubate the bacteria, they do not have TB disease. “That means that we can only know whether or not they have the infection by testing, after which we put them on treatment before the disease develops,” Dr Sitienei adds.

Overall, without treatment, it is estimated that about five to 10 per cent of infected persons will develop TB disease at some time in their lives.

“That is why we need to kill the bacteria,” he says.

A person needs to inhale only a few of these germs to become infected.

However, persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, are at a much higher risk of falling ill.

ADHERENCE

Kenya is among 22 countries considered to have a high burden of TB, including multidrug-resistant TB (MDR-TB).

“One of the biggest challenges is poor adherence to medication. Some of the contributing factors to this include the ongoing drought and lack of water. TB kills very fast because the powerful drugs make patients quite hungry, and if there is nothing to eat they will simply not take the drugs,” Dr Sitienei explains.

Meanwhile, researchers at the Massachusetts Institute of Technology (MIT) have developed a new way to deliver antibiotics in an effort to reduce healthcare costs and cure more patients.

The device consists of a coiled wire loaded with antibiotics, which is inserted into the patient’s stomach through a nasogastric tube whose shape can change depending on temperature.